Healthcare Provider Details

I. General information

NPI: 1013627488
Provider Name (Legal Business Name): CAROLINE HAAS WINDHAM DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 MEDICAL PARK DR
HICKORY NC
28602-8809
US

IV. Provider business mailing address

PO BOX 5105
BELFAST ME
04915-5100
US

V. Phone/Fax

Practice location:
  • Phone: 828-324-2800
  • Fax: 828-294-9141
Mailing address:
  • Phone: 828-324-2800
  • Fax: 828-294-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP13173
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: